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The Gauteng department of health is considering drastic action against doctors, nurses and other healthcare workers who have failed to disclose their financial interests in terms of the department's policies meant to guard against conflicts of interest.
According to the spokesperson of the Gauteng health department, Motaletale Modiba, out of the 14 116 health officials in the department meant to file disclosures, only 5 380 (38.11%) adhered to the call of the Public Service Commissioner. This means that 8736 or nearly two-thirds of employees did not comply.
In addition, only 309 out of 331 employees at the department's central head office disclosed their financial information before the financial disclosure system for all categories except the senior management service level closed on 31 July 2023.
The department is now threatening to issue suspensions to some of these healthcare workers and officials, after subjecting them to disciplinary hearings.
The question, however, is who will run the province's healthcare facilities if more than half the staff are suspended?
What are the disclosures for?
The disclosure is mandated in terms of the Public Service Act Regulation of 2016 chapter 2(2), which includes a directive that calls for designated employees to disclose their financial interests.
These include senior management and other employees of any government department as designated by the minister for public service and administration.
In the case of management and those working in the supply chain management sector of the health department, the disclosures are obviously meant to ensure that conflicts of interest in terms of tenders and other business interests are eradicated.
"The lack of compliance with financial disclosure might result in employees conducting business with the state without being detected, resulting in conflict of interest and increased unethical behaviour and misconduct," Modiba said.
For doctors and nurses, the disclosures are supposedly meant to prevent healthcare staff from moonlighting in the private sector or holding other jobs besides their government employment without proper permission.
Healthcare workers are only allowed to work in their private practices or take on private sector jobs once approval for remunerative work outside the Public Service (RWOPS) has been obtained.
Modiba explains the need for this prohibition:
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Threats to suspend non-compliant staff
An email was sent to health department employees last week, informing those who failed to do these disclosures for the past financial year that they were expected to attend a meeting at the MEC's office on Wednesday morning to personally explain their failure to submit the disclosures.
In the email that City Press has seen, the department's acting chief risk officer Canada Matsaneng instructed all the staff who missed the deadline to report to MEC Nomantu Nkomo-Ralehoko's office.
A section of the email reads:
"Colleagues will remember that MEC granted all those who did not comply a special remission with the proviso that this shall never happen again. You are all directed to ensure that all those officials make themselves available at the MEC’s boardroom tomorrow morning at 08H30am sharp to explain themselves to the MEC in person. Failure to ensure this happens will be the responsibility of the respective accounting officers (CEOs, district managers, entity managers, chief directors at head offices) and consequence management will follow. The head office ethics and integrity team together with human resource management will be on-site to ensure that all those identified will be dealt with accordingly."
It is unclear whether anyone reported for the meeting, but City Press is aware of at least one hospital which instructed its employees not to attend, as this would have meant several departments would have had to shut down for the day.
These employees were asked to sign declarations that they understood the directive to disclose such information, following the delay in submitting this information.
The declaratory forms state that the doctors certify that they have understood the expectations and requirements with regard to compliance with the ministerial directive on financial disclosure in line with the Public Service Regulations of 2016, chapter 2, part 2.
Modiba explained that it may now be necessary to act against these doctors:
Modiba further said that members of the senior management service (SMS), including HODs, should by no later than 30 April of the year in question disclose to the relevant HOD and executive authority, particulars of their financial interests in respect of the previous financial year [Regulations 18(1) and 18(2)].
The financial disclosure form should be submitted electronically using the e-disclosure system.
"Any member of SMS who fails to disclose his/her financial interests in line with PSR Regulation 18 is guilty of misconduct. "Disciplinary actions are taken against him/her," added Modiba.
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Disruption to health services when employees are disciplined?
According to sources, one West Rand hospital might be completely crippled by the department's threatened action, since entire departments failed to disclose their interests.
Doctors at the hospital said their entire orthopaedic and gynaecology departments had failed to submit their disclosures.
They cite the excessively personal nature of some of the questions as their reasons for doing so, saying they consider these an invasion of their privacy.
Two others said when they tried to submit their declarations, they were prohibited multiple times by a technical glitch, since they were previously employed in another province and the system refused to accept their details.
All these workers now face disciplinary action, and possible suspensions, which they say could be as long as three months without salaries.
Asked about the continuation of operations, since the department expressed its intention to follow through with the disciplinary actions, Modiba said: "It is misleading to use the issue of service disruption to not want to comply with the law. Notices were given long ago for designated categories of employees to comply."
He explained that a call that was made on 2 October for employees who did not comply with the requirement to disclose their private financial information by 3 October was actually more of an extended grace period. All employees will be given an additional two weeks to comply before facing consequences.
The department did not specify whether accounting officers were among the 22 staff that failed to disclose the information.
Modiba responded:
SAMA concerned about POPIA compliance
Meanwhile, the SA Medical Association (SAMA) has expressed grave concern over the protection of financial information. The spokesperson of SAMA, Nomonde Sussman, said:
“(SAMA) is not against the disclosure itself and does not dispute the legality thereof. In general, SAMA members are compliant. The association is, however, concerned about the security and protection of the supplied personal and financial information in line with the Protection of Personal Information Act No.4 (POPIA) of 2013.”
Sussman adds that the association communicated the concerns on 6 September 2023 to the health department, requesting them to indicate the measures in place to ensure compliance and safeguarding in line with POPIA.
She said that, regrettably, the department had failed to respond to the communication with the requested assurances and clarifications.
